Screening for Osteoporosis in Nonagenarians: A Scoping Review

Area of Science:

• Geriatric Medicine
• Bone Health Research
• Public Health Policy

Background:

• The aging US population necessitates focused care for nonagenarians (90+ years).
• Fragility fractures and subsequent mortality are significant concerns in the oldest old.
• Current osteoporosis screening guidelines lack age-specific recommendations for older adults.

Purpose of the Study:

• To review the literature on osteoporosis screening and intervention in nonagenarians.
• To identify benefits and limitations of current practices for this age group.

Main Methods:

• A comprehensive scoping review following PRISMA guidelines was performed.
• Literature search included major databases from 2018 to present, yielding 3346 studies.
• Twenty-one articles met inclusion criteria for analysis.

Main Results:

• Key themes included evaluating existing screening guideline effectiveness.
• The utility of new screening tools and fracture risk calculators was assessed.
• The role of frailty, multimorbidity, and treatment disparities in osteoporosis management were examined.

Conclusions:

• Osteoporosis screening and management are inadequately studied in nonagenarians.
• A discrepancy exists between current guidelines and clinical decision-making for the oldest old.
• Future research should prioritize nonagenarians to inform predictive models and screening recommendations.